Nutritional Outlook

Nutritional Outlook, April 2018

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NUTRITIONAL OUTLOOK ■ 43 APRIL 2018 both signif cantly lowered in the vitamin D group at 90 days compared to placebo. Furthermore, vitamin D also resulted in a signif cantly higher expression of the genes encoding for cathelicidin, an antimicrobial peptide secreted by colonic epithelial cells that is protective of colon health. T us, vi- tamin D administration led to a signif cant anti-inf ammatory ef ect in individuals with ulcerative colitis. More Research Ahead Vitamin D is a prohormone-like vitamin that has a broad range of activity in the hu- man body. Several functions are related to its inf uence and modulation of important aspects of the immune system, particularly key pro-inf ammatory cytokines. Downregu- lation of these cytokines leads to systemic anti-inf ammatory ef ects. Ensuring optimal intake of vitamin D through supplementa- tion allows for the repletion of this vitamin and for critical physiological processes to function well. Since the prevalence of chronic pain syndromes is so high amongst the general population—and the prevalence of vita- min D insuf ciency is concomitantly high, especially in these individuals—vitamin D supplementation seems like a no-brainer, as well as a critical f rst step in ensuring the body is wired to deal with the pain it is suf- fering by balancing out the inf ammatory process. While vitamin D may not be the answer or an alternative to highly addictive pain medications all by itself, supporting the body's normal physiology by ensuring it has all the necessary building blocks can allow it to return to its natural healthy state and likely lessen the need for more drastic interventions. References 1. Mansf eld KE et al., "A systematic review and meta-analysis of the prevalence of chronic widespread pain in the general population," Pain, vol. 157, no. 1 ( January 2016): 55–64 2. Volkow ND et al., "Opioid abuse in chronic pain—misconceptions and mitigation strategies," New England Journal of Medicine, vol. 374, no. 13 (March 31, 2016): 1253–1263 3. Menzies V et al., "Polypharmacy, opioid use, and chronic widespread pain: a secondary analysis of clinical trial data," Biological Research for Nurs- ing. Published online July 18, 2016. 4. Helde-Frankling M et al., "Vitamin D in pain management," International Journal of Molec- ular Sciences, vol. 18, no. 10. Published online October 18, 2017. 5. Forrest KYZ et al., "Prevalence and correlates of vitamin D def ciency in US adults," Nutrition Research, vol. 31, no. 1 ( January 2011): 48–54 6. Ghai B et al., "Vitamin D supplementation in pa- tients with chronic low back pain: an open label, single arm clinical trial," Pain Physician, vol. 20, no. 1 (January–February 2017): E99–E105 7. Kuru P et al., "Hypovitaminosis D in wide- spread pain: its ef ect on pain perception, quality of life and nerve conduction studies," Rheumatology International, vol. 35, no. 2 (February 2015): 315–322 8. Akyuz G et al., "T e ef ect of vitamin D supplementation on pain, quality of life, and nerve conduction studies in women with chronic widespread pain," International Jour- nal of Rehabilitation Research, vol. 40, no. 1 (March 2017): 76–83 9. Gendelman O et al., "A randomized double- blind placebo-controlled study adding high dose vitamin D to analgesic regimens in pa- tients with musculoskeletal pain," Lupus, vol. 24, no. 4-5 (April 2015): 483–489 10. Rodriguez AJ et al., Ef ects of vitamin D supplementation on inf ammatory mark- ers in heart failure: a systematic review and meta-analysis of randomized controlled tri- als," Scientific Reports. Published online Janu- ary 18, 2018. 11. Tabatabaeizadeh SA et al., "High dose sup- plementation of vitamin D af ects measures of systemic inf ammation: reductions in high sensitivity C-reactive protein level and neutrophil to lymphocyte ratio (NLR) distri- bution," Journal of Cellular Biochemistry, vol. 118, no. 12 (December 2017): 4317–4322 12. Sharif A et al., "A randomized controlled trial on the ef ect of vitamin D3 on inf am- mation and cathelicidin gene expression in ulcerative colitis patients," Saudi Journal of Gastroenterology, vol. 22, no. 4 ( July-August 2016): 316–323 Irfan Qureshi, ND, is executive direc- tor, research and regulatory af airs, for Healthy Directions.

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